Provider Demographics
NPI:1053302588
Name:WINTER-RUNDELL, CHRISTINE M (OD, FCOVD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:WINTER-RUNDELL
Suffix:
Gender:F
Credentials:OD, FCOVD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:CORELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:4207 GLASS RD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402
Mailing Address - Country:US
Mailing Address - Phone:319-366-4455
Mailing Address - Fax:319-362-8461
Practice Address - Street 1:4207 GLASS RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402
Practice Address - Country:US
Practice Address - Phone:319-366-4455
Practice Address - Fax:319-362-8461
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2301152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0760058Medicaid
IA39574OtherWELLMARK BCBS
IA0760058Medicaid
IA39574OtherWELLMARK BCBS